An experimental injection that switches off the liver's production of an inherited cholesterol-carrying blood particle, which diet and standard cholesterol drugs barely move. A single injection lowers it deeply and holds it down for roughly a year — an effect that cannot then be withdrawn. Whether lowering prevents heart attacks remains unknown, and access is limited to registered trials. (Full Review)
| Marker | Target | Why |
|---|---|---|
| Lipoprotein(a) | Below 75 nmol/L; below 30 preferred | The direct target; sets eligibility and response |
| Apolipoprotein B | Below 80 mg/dL; 60 with arterial disease | Counts every artery-damaging particle |
| LDL cholesterol | Below 70 mg/dL | Tracks the accounting shift from removing Lp(a) |
| ALT and AST | Below 25 U/L (men below 30 U/L) | Detects the transaminase rise from liver delivery |
| Total bilirubin | 0.3–1.0 mg/dL | Separates a benign enzyme rise from liver injury |
| eGFR | Above 90 mL/min/1.73 m² | Unbound drug is partly cleared by the kidney |
| hs-CRP | Below 1.0 mg/L | Inflammation transiently inflates an Lp(a) reading |
| HbA1c | 5.0–5.4% | Watches the speculative metabolic signal at very low Lp(a) |
| Platelet count | 175–250 ×10⁹/L | Screens for platelet decline seen with some nucleic-acid drug classes |
Cadence: Baseline: two Lp(a) results on one assay platform, four weeks apart and four weeks clear of acute illness. Then liver enzymes at 4 and 12 weeks; Lp(a) at 12 weeks for the nadir; Lp(a), apolipoprotein B and liver enzymes at 6 and 12 months, then annually before each injection.